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General NPI Number Information
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NPI Number | 1114948288
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Entity Type | Organization
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Legal Business Name | GRAVES GILBERT CLINIC PLLC
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Dates
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Enumeration Date | 07/22/2006
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Last Update Date | 10/22/2025
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Provider Practice Location Address
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Address Line | 201 PARK ST
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City | BOWLING GREEN
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State | KY
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Zip | 42101-1742
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Country | US
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Telephone | 270-781-5111
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Fax | 270-783-3750
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Provider Business Mailing Address
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Address Line | 201 PARK ST
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City | BOWLING GREEN
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State | KY
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Zip | 42101-1708
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Country | US
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Telephone | 270-781-5111
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Fax | 270-783-3750
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Authorized Official
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Title or Position | CEO
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Name | MICHAEL E D'ERAMO
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Credential | DHA
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Telephone | 270-780-0549
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number |
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License Number State |
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Taxonomy #12
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State | KY
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Taxonomy #13
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number |
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License Number State | KY
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Taxonomy #14
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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